Fungal Infections

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Fungal Infections

• Reena Doshi

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Two major groups

• Candida
• Dermatophyte

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Candidiasis Genital

• Women gt Men
• Itchy, sore vulvovaginitis
• White plagues on mucous membranes
• White cheesy discharge

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Candidiasis Genital
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Candidiasis Intertrigo

• Red, moist, glazed, itchy
• Submammary, inguinal, axillary folds
• Occasionally between digits

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Candidiasis Intertrigo
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Candidiasis Oral

• Babies, pts with poor oral hygiene, elderly with
  false teeth
• Sore mouth
• Poor feeding
• White plaques on buccal mucosa wipe off
• Angular stomatitis

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Candidiasis Oral
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Candidiasis Nappy

• Babies
• Nappy area

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Candidiasis Chronic paronychia

• Wet workers
• Chronic nail bed inflammation

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Candidiasis Systemic

• Immunosupressed pts
• esp. HIV,malignancy
• Red skin nodules

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Candidiasis Systemic
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Tinea infections

• Obtain scrapings/clippings before starting
  treatment

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Tinea Corporis Ringworm

• Trunk/limbs
• Plaques with scaling and erythema esp. at edges
• Lesions enlarge slowly and clear centrally

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Tinea Corporis Ringworm
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Tinea Cruris

• Groin, upper thigh (scrotum)
• Common in athletes
• Men gt Women
• Red plaque with scaling esp. at the edge
  central clearing with active edge
• Assoc. with tinea pedis

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Tinea Cruris
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Tinea Pedis Athletes Foot

• Feet
• Young gt Old
• Men gt Women
• Itchy maceration between toes esp. 4th/5th
• RFs
• Swimming
• Occlusive footwear
• Hot weather
• Communal showers

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Tineqa Pedis
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Tinea Capitis

• Hair and scalp
• Defined inflammed scaly areas
• May have alopecia with broken hair shafts

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Tinea Capitis
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Tinea Unguium

• Nails
• Old gt Young
• Toenails gt Fingernails
• Distal to proximal spread
• Thickening, yellowing and crumbling of nail plate
• Assoc with tinea pedis

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Tinea Unguium
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Management Topical

• Genital
• Imidazole cream, pessaries
• Nail
• If 1-2 nails only lacquer or paint (1-2x/week)
• Skin
• Imidazole cream , spray, powder
• Terbinafine cream
• Mouth
• Tongue deposits-brush bd
• Oral pastilles, suspensions, gels eg nystatin,
  miconazole

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Management Systemic

• Recurrent, systemic, extensive or resistant
  infection
• Genital candida 200mg fluconazole stat
• Oral/mucocutaneous/systemic candida
• Eg. Oral fluconazole (1-2/52)

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Management Systemic

• Dermatophyte
• Oral terbinafine or itraconazole daily
• Skin 2-4/52
• Nails 3/12

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Thank You!